Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $366.95 / $832.98 / $869.67	Facility		$366.95	$832.98	$869.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.10 / $366.95 / $869.67	Professional		$255.10	$366.95	$869.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $489.38 / $489.38 / $489.38	Professional		$489.38	$489.38	$489.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $476.13 / $1,035.47 / $2,464.07	Facility		$476.13	$1,035.47	$2,464.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $355.97 / $467.63 / $2,915.38	Professional		$355.97	$467.63	$2,915.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.02 / $297.02 / $297.02	Facility		$297.02	$297.02	$297.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.82 / $216.82 / $423.66	Professional		$216.82	$216.82	$423.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $300.56 / $543.75 / $1,408.20	Facility		$300.56	$543.75	$1,408.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $543.75 / $966.52	Professional		$302.39	$543.75	$966.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $375.17 / $416.86 / $458.54	Professional		$375.17	$416.86	$458.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $431.65 / $489.38 / $543.75	Facility		$431.65	$489.38	$543.75
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $455.53 / $543.75 / $598.13	Professional		$455.53	$543.75	$598.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $476.13 / $610.66 / $1,062.02	Facility		$476.13	$610.66	$1,062.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $517.54 / $531.01 / $531.01	Facility		$517.54	$531.01	$531.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $431.98 / $462.19 / $598.13	Professional		$431.98	$462.19	$598.13
United Facility/Professional Professional Modifier Low / Median / High Price $210.12 / $227.63 / $433.58	Professional		$210.12	$227.63	$433.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $276.35 / $297.54 / $297.54	Professional		$276.35	$297.54	$297.54